Running head: PERSUASIVE ASSIGNMENT

Student No. N00180321

Persuasive assignment: Nurses take the initiative on assisted suicide

Student Name: Lara Pabandero-de Lasan
Student No.: N00180321
Date Submitted: October 2, 2015
NURS217 (366): Legal, Professional and Ethical Issues in Nursing Practice
Professor:
Humber College ITAL

Running head: PERSUASIVE ASSIGNMENT

Student No. N00180321

Persuasive assignment: Nurses take the initiative on assisted suicide

Euthanasia, also called mercy killing, the deliberate causing of the death of a person
who is suffering from an incurable disease or condition (Mosby, 2013 p.652), is often a
controversial and ethical debate in Canada. Assisted suicide also known as assisted death or
dying, is a form of euthanasia, when a patient or client desires to end their life but need
assistance from a healthcare professional (HCP), such as a nurse, as there is a lack of resources,
ability or knowledge to be successful, however the person assisting may be breaking the criminal
code, and can be held responsible in their actions with the law (Mosby, 2013 p.147). The main
difference of the two are: euthanasia is performing the act of causing the harm to the patient such
as administering the lethal injection to achieve death, but assisted suicide is providing the
resource to the patient but the patient will do the actual harm to themselves like ingesting the
prepared lethal dose of medication knowing that the result will be death.
The Supreme Court of Canada (2015) recently legalized assisted suicide in February of
this year however gave a grace period of 12 months for further preparations and thorough
deliberation. Because this is an ethical and legal dilemma, there is a waiting game with the
provinces, the federal government, and Canadian Medical Association for guidelines or criteria
until concrete parameters are put in place; however it was very interesting to read in The Star by
Goar, (2015) that the Registered Nurses Association of Ontario (RNAO) bravely dedicated their
90th annual meeting on end-of-life care inviting expert panel members of HCPs and attendees of
500 nurses, medical professionals and citizens to express their difference in opinions. For or
against it, the goal was to initiate discussion and the community become aware. For the purpose
of this paper, the stance is in support of assisted suicide, three arguments to be made are nursing
ethical values essential to care for, in this instance, the dying: client well-being, client choice,

Running head: PERSUASIVE ASSIGNMENT

Student No. N00180321

and respect for life. The voice of nurses is important since they spend the most time with the
patient.
Nursing Practice Standard - Ethical Values
It is instilled in nursing students that the very core of nursing is client centered care which
means that everything should be for the benefit of the patient. College of Nurses of Ontario
(CNO) established nursing ethical values that nurses must abide by in order to practice client
centered care and first on that list is to promote client well-being by facilitating the clients
health and welfare, and preventing or removing harm (2009, pg.5). Technological
advancements have enhanced HCPs to allow or assist people to die when appropriate, when in
the best interest of patients. It is the nurses duty to put the clients welfare first or the optimal
good, and prevent or remove the problem that will cause the client any harm. If the patient
believes that being alive is more harm from excruciating chronic pain they are experiencing for
example from chemotherapy and radiation treatment in cancer that has already progressed
terminally, it is the responsibility of the HCP to remove that harm from the patient. Pain is very
subjective, only the patient experiences it and truly knows the extent of agony they are facing. In
end-of-life care, pain management or pain termination is a big aspect, but how much analgesic
can be given to maintain that therapeutic effect and not overdose and prevent addiction?
Patients wishes have to be granted to the best of the nurses abilities because the patient is the
one experiencing the whole situation, everyone else are just bystanders and do not actually feel
the exact emotion of that patient. To be able to free the patient from all that suffering makes
assisted suicide easier to associate with.
Another nursing ethical value is to advocate for client choice, patients have selfdetermination and includes the right to the information necessary to make choices and to consent

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to or refuse care, so with essential information they can decide what is best for them because
they are the expert of their own life and act autonomously (CNO, 2009). The patients will and
right to decide for their own life should be a nursing priority especially when they are competent
enough to decide. Commonly seen in the elderly, are the Do Not Resuscitate (DNR) orders, an
advanced care directive that has been legally discussed by the doctor with the patient and their
family who have opted not to revive the persons heart once it has stopped. This is a similar
patient choice situation, a practice standard but assisted suicide is still a very big disagreement.
Another occurrence is the mothers informed choice of abortion, there is a time constraint of 20
weeks gestation nonetheless it is still a choice made; assisted suicide is similar in a way that life
is still lost in both situations, however one is legal and the other, not. A terminally ill patient of a
stage four cancer that have tried all possible interventions, decide that they desire death but need
assistance because they are in chronic excruciating pain and cannot bare it any longer, to have all
resources exhausted and cancer is still exponentially growing and killing the body makes death a
slow torture. Young and Ogden (2000) express the same sentiment when nurses defend this
stance by identifying the patients right to self-determination and the professional obligation
they feel to respect that right hence necessitating to grant the patients dying wish (p.515).
The last point is respect for life which means life is precious, it should be beautiful; this
also includes considerations of the quality of life (CNO, 2009, p.8). Respect is the recognition
of the inherent dignity, worth and uniqueness of every individual (CNO, 2006, p.3). It is
important to advocate for the clients dignity, to let them make the decision of hastening death to
avoid suffering any longer than they have to. Life is a gift; however what if that gift brought
along so much affliction? Nurses should be advocating for the patients benefit. To respect life,
the quality of life should be assessed, when the prognosis of the disease has progressed to

Running head: PERSUASIVE ASSIGNMENT

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uncontrollable limits and the patients quality of life is compromised, is it more compassionate to
prolong a life of suffering rather than ending it abruptly to end lifes misery? Many nurses and
personal support workers can attest to seeing how the elderly quality of life is more often than
not what they want if it were their own lives. Several residents in the nursing homes are
bedridden and hooked up to machines only awaiting death. Are they living a quality life?
Witnesses to those patients, would say no, they are breathing but not living a quality life, most
no longer remember anything and are only in constant pain or in a state of depression, which is
far from a good quality of life, especially at this end stage of the life cycle.
There have been debates about assisted suicide for many years. In refutation, those who
are against assisted suicide believe that life is sacred, religious reasons like a higher being (God)
only, is to decide about death and not humans. Or if an individual is suffering from chronic pain
or a terminal disease it is their fate or punishment for how they lived their life. The legal aspect
that assisted suicide is illegal in Canada and that there are no guidelines for who can opt for
assisted suicide and who cannot. What boundaries should there be, and which clinical diagnoses
can be eligible? These points are all very valid reasons and the list goes on that assisted suicide
is should not be common practice because of its sensitivity and ethical concern.
Conclusion
A patient is: a fetus in the mothers womb, a newborn from the labour and delivery, a
toddler who swallowed gum, an adult who has the flu or someone who is dying and wishing for
assisted suicide; regardless of the situation, they all need to be cared for in the best possible way.
Nurses must ensure client well-being, advocate for client choice and have respect for life.
Controversial and ethical situations will arise but that is why nurses have guidelines, practice
standards and other resources for assistance. Nursing is a very complex profession, nurses may

Running head: PERSUASIVE ASSIGNMENT

Student No. N00180321

have to deal with difficult situations because they are the ones who spend a lot of time with
patients and develop that trusting nurse-client relationship bond and make all the hardships
worthwhile. Nurses find a way to thrive and grow with each challenging circumstance and
charge it to experience to become wiser for the next patient needing care.
References
College of Nurses of Ontario (CNO). (2009). Practice standard: Ethics. Retrieved September 18,
2015 from http://www.cno.org/Global/docs/prac/41034_Ethics.pdf
College of Nurses of Ontario (CNO). (2006). Practice standard: Therapeutic nurse-client
relationship. Retrieved September 18, 2015 from
http://www.cno.org/Global/docs/prac/41033_Therapeutic.pdf
Goar, C. (2015, April 21). Nurses take the lead on assisted suicide: Goar. The Star. Retrieved
September 18, 2015 from
http://www.thestar.com/opinion/commentary/2015/04/21/nurses-take-the-lead-onassisted-suicide-goar.html
Mosby. (2013). Mosby's dictionary of medicine, nursing & health professions, 9th Ed. Mosby
Canada. VitalBook file, Pageburst.
Young, M. G. & Ogden, R. D. (2000). The role of nurses in AIDS care regarding voluntary
euthanasia and assisted suicide: A call for further dialogue. Journal of Advanced Nursing,
31, 513519. doi: 10.1046/j.1365-2648.2000.01304.x. Retrieved September 18, 2015
from Humber College Library Database.

Running head: PERSUASIVE ASSIGNMENT

Student No. N00180321